HEALTH
Dan Poulter Excerpts(12 years ago)
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Mr Deputy Speaker (Mr Nigel Evans)
For the wind-ups, the guideline on speeches is 10 minutes, but the clock will not be in operation.
The Parliamentary Under-Secretary of State for Health (Dr Daniel Poulter)
I have very much enjoyed sitting through this debate on health. I remember that when we had the equivalent debate last year, many speakers did not have the time they wanted to make their speeches. The fact that we have had longer today has enabled many right hon. and hon. Members to make valuable contributions on a number of subjects, focusing not only on health care issues in their constituencies and on important individual cases that highlight the need for changes in the system, but on the big challenges that face the NHS in tackling long-term medical conditions.
In the time available to me, I will do my best to answer the questions and points put across by Members on both sides of the House. My hon. Friend the Member for Stafford (Jeremy Lefroy) and I have met on a number of occasions, along with my hon. Friend the Member for Stone (Mr Cash), to talk through the challenges facing Mid Staffordshire trust. My hon. Friend the Member for Stafford has been a great advocate for, and a great support to, the patients and staff at that trust. I would like to put on record my thanks to him for all that he has done for all his constituents. His advocacy during his time in this House has been tremendous.
My hon. Friend the Member for Stafford raised some important issues. We know that it is desirable, not only because it makes good health care economics but, more importantly, because it is good patient care, to keep people well and looked after in their own communities and in their own homes. My hon. Friend threw up a legitimate challenge when he said that if we are to deliver good care in the community and in people’s homes, we need to find a way of moving from the current situation. At the moment we have a crisis management response by default, where people are rushed into A and E, and he is right to highlight the fact that some parts of the country do not have an adequate GP out-of-hours system to look after people around the clock. We need to ask how we go from a system set up around crisis management to one that is better placed to meet the future needs of preventive care and looking after people with long-term conditions such as diabetes, dementia and heart disease in their own homes and communities. The Government are taking steps to address this issue by making sure that GPs and local health care commissioners, through clinical commissioning groups at a local level, will hold a lot of the health care budget. That will ensure that the focus is on primary preventive care and on better looking after people with long-term conditions.
My hon. Friend is right to say that we need sufficient numbers of hospital beds, but as time passes there might less need for beds in some hospitals if local CCGs effectively meet the challenge of ensuring that that they invest in community and preventive care. In the interim, we need to support good commissioning of beds locally. We must have intermediate care beds available at community hospitals and in other care settings in the community for step-up care, step-down care and respite care.
On the other side of the River Thames, the clinical director of St Thomas’ hospital, Ian Abbs, is looking into year-of-care tariffs, which look after patients with long-term conditions such as diabetes and heart disease in a holistic way that enables them to be supported when they need a hospital bed and need to be looked after in the community. That has to be the right way forward. We in the Department’s ministerial team will work with clinicians, medical directors, trusts and commissioning boards to make sure that Eurocare tariffs are in place, so that we can shift the focus away from the community, but in a managed way that means that hospital beds will still be available as people require them.
The hon. Member for Easington (Grahame M. Morris) has been a strong advocate—he has raised his concerns many times—for constituents and others throughout his part of the country who are patients who need access to cancer care, cancer services, the cancer drugs fund and, indeed, high-quality radiotherapy. It is worth setting out some of the background—he outlined it himself in his speech—to the Government’s commitment to improving care for patients with cancer.
In 2011 the Government made a commitment to expand radiotherapy capacity by investing more than £150 million more over four years from 2011. As the hon. Gentleman knows, that was to increase the utilisation of existing equipment, support additional services and ensure that all high-priority patients with a need for proton beam therapy get access to it. In April 2012, the then Secretary of State announced that the Department had set aside up to £250 million of public capital, to be invested by the NHS in building proton beam therapy facilities at the Christie hospital in Manchester and the University college London hospital, to treat up to 1,500 patients each year. In October we announced a £15 million radiotherapy innovation fund for 2012-13, which brings this Government’s additional investment in radiotherapy over the spending review period to more than £165 million. The fund is designed to ensure that, from April 2013, radiotherapy centres will be ready to deliver intensity-modulated radiotherapy to all patients who need it.
The hon. Gentleman was right to say that, in spite of that increased investment, there are ongoing concerns about the variability of access to radiotherapy services in the NHS. I hope that it will reassure him that, in response to the requests of radiotherapy centres to the fund, we will go beyond the original commitment and will this week notify the centres of allocations totalling almost £23 million. We have taken on board the hon. Gentleman’s concerns and are making sure that we continue to invest in high-quality radiation in the years ahead. I know that he will hold the Government to that task in the coming years.
The right hon. Member for Wentworth and Dearne (John Healey) has rightly raised issues of principle arising from the Vinny Duggan case. I want to put on record my best wishes to the family concerned. I will deal with two issues: first, the issue that arose from the way in which the trust handled the complaints procedure, and secondly, the wider point about the Nursing and Midwifery Council.
First, as the right hon. Gentleman has highlighted, the trust clearly failed to acknowledge to any adequate degree that mistakes happened and that the quality of care was not of the standard that it should have been. That much was clear in this regrettable episode in the trust’s history. Two years is an unacceptable amount of time to wait for an apology or for an adequate explanation for what went wrong. The right hon. Gentleman is absolutely right to say that what patients want when things go wrong is a sincere apology and an explanation as to why things happened. We all know, no matter how good the care is in the NHS, that bad things will sometimes happen, but we need to know that that mistake has been recognised, that there has been an apology and that lessons have been learned for the future. We cannot rewrite history or always unpick mistakes, but we can learn lessons for the future and make sure that such bad things do not happen again. That is what good medicine is about. Clearly, in this case there were problems with the way in which the complaints were addressed.
Secondly, on the wider point raised by the right hon. Gentleman about the NMC and the disparity between how different professional regulators approach the complaints process, he is right that the NMC can review or reopen a case only when new evidence is available. If old evidence is reconsidered or if it changes, as in this case, it is very difficult to review it. There are differences between the medical and other professional regulators with regard to how such cases are handled, and the Law Commission has rightly highlighted those inconsistencies. There needs to be more consistency throughout all parts of the medical, nursing and allied health professional groups, in order to make sure that patients know that, when complaints are made and concerns are aired, they will be looked into and, where necessary, complaints can be reopened and reinvestigated.
The Law Commission proposals are expected to be introduced to the House in 2014. The right hon. Gentleman asked whether we could do anything sooner than that, but, as he will know, if we brought in a section 60 order, it would take about two years for it to get through the full parliamentary process. Given that the Law Commission proposals are holistic and apply to not just the NMC, but all health professions, we believe that the right approach is to consider those proposals in 2014. We hope that that will bring a lot more consistency, which I think we all feel is desirable, to future cases involving the professional conduct of all medical, nursing and other health care professionals.
I thank my constituency neighbour, my hon. Friend the Member for Suffolk Coastal (Dr Coffey), for her kind comments about the work that I, other Suffolk MPs and, indeed, the Minister of State, Department of Health, my hon. Friend the Member for North Norfolk (Norman Lamb), have done in relation to problems with the East of England ambulance service. People in more rural counties, particularly North Norfolk and parts of Suffolk, appear to be getting a service that is not of the standard that we would expect. We need more transparency with regard to response times, not just on a regional level, but on a county-wide level. My hon. Friend the Member for Suffolk Coastal asked whether there could be a breakdown by postcode. That is a little more challenging, because it is possible that, in any given month or response period, not enough people in a particular postcode will need an ambulance. There is a desire, however, for more transparency with regard to sub-geographical regions.
My hon. Friend the Member for Waveney (Peter Aldous) has also taken a keen interest in the issue and has recently been out with the ambulance service on a number of evenings.
Peter Aldous (Waveney) (Con)
I am grateful to my hon. Friend the Member for Suffolk Coastal (Dr Coffey)for raising the issue and to my hon. Friend the Minister for responding. Having been out with the ambulance service, I have two observations. First, does the Minister agree that we have tremendous, dedicated staff and that we owe it to them to work with the management and others to get the service right? Secondly, the problems facing the service are diverse and multiple, but they can be solved with a lot of effort. For example, on the particular problem of blocking at hospitals and handing over to them, James Paget hospital in Galston has shown that, when the hospital and ambulance service work together, the problem can be solved.
Dr Poulter
My hon. Friend is absolutely right and I pay tribute to him for taking the time to go out with the ambulance service and see first hand the problems that have been experienced in some parts of Suffolk and Norfolk. There have been problems with the handover time at some hospitals in the east of England and that is clearly unacceptable, because if the ambulance and hospital staff are engaged in lengthy handovers, it means that other patients are not being treated and seen in a timely manner. Those issues need to be addressed by some trusts in the east of England.
My hon. Friend the Member for Waveney has written to the ambulance service and his letter was made available to my noble Friend Earl Howe. In it, he highlighted the trust’s decision to publish more performance information online from February and stated that it was important that that was done by geographical area to ensure that there is greater transparency in the quality of response data in areas such as Beccles and Bungay, relative to more urban areas such as Ipswich. That is an important point. I urge him and my hon. Friend the Member for Suffolk Coastal to continue pushing for transparency in the ambulance service’s data, and to continue their fight for improved response times for more rural areas of Suffolk and Norfolk. I know that my noble Friend Earl Howe would be happy to meet hon. Members to discuss the matter further.
Let me turn to the issues that were raised by the other three Members. I will be brief, Mr Deputy Speaker, because I take your hint. My hon. Friend the Member for High Peak (Andrew Bingham) raised concerns about a number of ambulance stations, including one in Buxton. I know that my hon. Friend the Member for Staffordshire Moorlands (Karen Bradley), who lives in a nearby constituency, shares those concerns. A review is currently taking place. We all welcome reviews if they are going to improve the quality of care for patients and improve ambulance response times. However, there are local concerns that the review must take into account issues such as rurality and the difficulties that patients on high land or in harder-to-access areas have in accessing all types of health care services.
I note the concerns that the review is making proposals that do not necessarily take account of those factors. My hon. Friend the Member for High Peak has put those concerns on the record today. If that has happened, I echo his concerns, because it is important, in the review of any service, that issues such as rurality and difficult-to-access areas are taken fully into account. This is, of course, a local health care decision. If he wants to discuss the matter further with Ministers, we are happy to discuss it with him.
The hon. Member for Lewisham West and Penge (Jim Dowd) put across his strong advocacy for Lewisham hospital. I trained in south Thames and have colleagues who work at Lewisham hospital. We all know that Lewisham faces particular challenges. It has demographic challenges, given its difficult population groups with considerable health care needs, and great health care inequalities. It has a large migrant population, which brings particular health care challenges and means that people do not always have English as a first language. Such people need to be looked after properly. It is important that those issues are taken into account during the discussions.
I take on board the concerns of local staff that they are being drawn into the big financial concerns with South London Healthcare NHS Trust. However, we also have to recognise that no one hospital operates in a vacuum. We must ensure that hospital services and the care that is provided reflect the needs of the wider geographical area. My right hon. Friend the Secretary of State will be looking into these issues.
Dr Poulter
I will take an intervention very quickly, but I am pressing on Mr Deputy Speaker’s patience.
Jim Dowd
Nobody disputes the Minister’s last point. That is why there is a reconfiguration process especially for that purpose. That is what should be used, rather than this back-door method.
Mr Deputy Speaker (Mr Nigel Evans)
Order. Please complete your contribution within 60 seconds, Minister, so that we can move on.
Dr Poulter
I will do so, Mr Deputy Speaker.
I am sure that my right hon. Friend the Secretary of State will take those considerations into account when he receives the report and comes to his conclusions in due course. I know that the hon. Member for Lewisham West and Penge will continue to make his views clear.
Finally and importantly, I turn to the good remarks made by the right hon. Member for Leicester East (Keith Vaz). He is right to point out that one of the big challenges facing this country in health care terms is to better look after people with long-term conditions. Diabetes is a key challenge. Patients with diabetes have a higher risk of coronary heart disease, stroke, amputation, vascular disease and a number of other medical problems. One key way to deal with that is to focus more on prevention, rather than cure. That means investing in more GP-led care and primary prevention, rather than picking up the pieces in hospital. We should focus on helping people with type 1 diabetes to have a normal life by educating them to understand their condition, through the use of insulin pumps and by helping younger people to manage their condition.
The Government are committed to preventing diabetes and bad lifestyle habits from developing in the first place by focusing on better education in childhood. When local authorities have control of public health budgets, that will be a key priority for them. We must set good lifestyle habits from the early years to ensure that people do not develop diabetes later on.
Thank you, Mr Deputy Speaker.
Transport
Phil Wilson (Sedgefield) (Lab)
I want to take this opportunity to raise an issue that is helping to fill my postbag at the moment: the state of rural bus services in County Durham and Darlington. I know that that is a concern for many MPs, especially those in County Durham. Only yesterday, I received a petition from Aycliffe village signed by 300 people, which complains about the state of rural bus services in the area and the lack of buses, especially in the evening.
Sedgefield covers part of south Durham and all the rural parts of Darlington borough. It covers about 150 square miles and, for people without a car, travelling from A to B can be a big problem. Car ownership in County Durham is below the national average. Almost 30% of households are without a car, compared with about 25% nationally. For those on low wages, the elderly, young people and disabled people, getting around the constituency can be a chore. The Government’s approach to cutting bus subsidies and their more general cuts to local government are making the situation worse.
I could spend the rest of my speech talking about the severity of the Government’s cuts, but the Government would just say that the problem is the way in which the local authority is introducing the cuts. We could go on in that vein, but it would not resolve anything. When a constituent comes to my office—as constituents do from time to time—and says that he cannot get to work because the buses have changed, he wants a solution. He does not want to hear what will happen in the future or an argument about who is to blame; he wants me to tell him how he can get to work in the morning. I want to say a little about what some of my local communities are doing to provide community transport, because what people are looking for—the elderly and the low-paid—is a solution to the problems.
People in communities such as Hurworth, Middleton St George, Sadberge and Brafferton in the Darlington part of my constituency are working with the Community Transport Association and Darlington borough council to assemble a workable community transport service for the area to help people who are suffering because of the lack of an adequate bus service. I hope that the Minister can offer his support and encouragement to the stakeholders of that scheme to ensure that it is a success.
Durham county council already runs a community transport service called Link2, which provides a community service in areas where commercial bus services do not want to go. I congratulate the county council on providing that service. It has seen its budget for bus services reduced by about £1.3 million. The rural bus subsidy grant for the county has been cut by about 40%. Companies such as Arriva are therefore not receiving the subsidy that they received in the past, so they are pulling buses off routes, which is making it difficult for my constituents to get around. I have constituents who are having difficulties in getting to work, whose journeys have been lengthened and who cannot take up jobs that they want because they are unable to get to the place of work. Does the Minister agree that although cuts to bus subsidies might make savings in some areas, they create costs elsewhere? Will he say whose responsibility it is when vulnerable people fall through the transport net because of the cuts?
To give an example, I have an elderly constituent who does not want to be named, but who wants me to relay her story because she believes that what is happening to her is also happening to others. My constituent is a 75-year-old pensioner who looks after her 50-year-old daughter who has Down’s syndrome and serious medical conditions. They often rely on friends and family to get to a doctor’s appointment, but one day family and friends were not available, there were no taxis, and buses no longer ran a convenient distance from their home. The doctor’s surgery was about a mile away so my constituent decided to walk there with her daughter. Such a journey might take a fit person about 15 minutes, but it took my constituents considerably longer and on the way back they had to stop at the community centre and ask someone for a lift to get back home. Such things are happening day in, day out, not just in County Durham but all over the country. The Government may argue that this level of cuts is necessary. That is fair enough, but surely someone must take responsibility for the consequences of those cuts.
Another constituent of mine, 16-year-old Lauren Peters, attends New College Durham. A few weeks ago she was stranded at Durham bus station. The bus service had been cut due to inclement weather, but the bus company did not alert local colleges about the difficulties. My constituent was stranded without any money and the battery on her phone was about to run out. She had to wait in the cold, damp, bad weather for three hours before her father could come to pick her up.
We understand that bad weather can cause disruption, but where was the customer care from companies such as Arriva, one of the biggest bus companies in Europe? There was no phone call to local colleges or major employers. I have written to Arriva and the county council, and although I have received a reply from the county council I have yet to hear anything from Arriva. Mrs Peters contacted me the next day to raise the issue and complain. If bus companies are now running merely commercial routes—I believe the route in question was commercial—surely we need better alert systems when there is disruption to help people to get home. There seems to be no customer care.
Lauren was not the only vulnerable person affected by the disruption that day. I want solutions to the issues I have raised. I want to work with community groups to establish community bus services where possible, and available funding to be used to that effect where subsidies to existing bus services have been withdrawn.
I know that Durham county council has gained about £374,000 from the rural sustainable community transport initiative, but that is a one-off grant; it does not happen every year. These are austere times and we should be all in this together. My question to the Minister is this: if this level of cuts is necessary, who is taking responsibility for those who fall through the net? Although I will help local authorities and communities as best I can to establish community bus services, does the Minister agree that there is only so much that the local community can do?
House of Lords Reform Bill
Dan Poulter Excerpts(12 years, 5 months ago)
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Andrew Griffiths (Burton) (Con)
Having sat through the whole of this debate, let me say first that I am grateful to be called, but secondly that I pay tribute to the way in which this debate has been conducted. It has been thoughtful and, on the whole, respectful. It has actually moved the debate forward.
I rise with some sorrow because I consider myself a loyal Back Bencher. I have tried my best in my two years in this place to support my Government in their legislation, but for the first time I am faced with the decision of having to vote against my Government and against my Prime Minister. I do so with no relish and with a heavy heart, but I think many of us have come to the conclusion that we simply cannot accept this Bill. It is bad for the country, it is bad for Parliament and it is bad for our constituents. For that reason, I will vote against the Government tonight. I do that not to give the Prime Minister a bloody nose, not to send a message about the coalition, not even to upset my Lib Dem coalition colleagues—I always prefer to put work before pleasure.
A number of colleagues have mentioned the e-mails they have received from their constituents—some for and some against the Bill, but all in small numbers. I received an e-mail from a constituent this morning, which said, “Dear Mr Griffiths, Yesterday I was made redundant. Why is Parliament spending its time navel gazing?” That, I think, is the heart of the matter. Parliament is looking inward rather than looking outward, at the challenges that we face in governing the country.
It is difficult for me to reconcile some of the promises that we have been given with what will actually happen. We have been promised that there will be no conflict between this House and the newly elected House of Lords, but that promise fails to take account of the nature of the beast with which we are dealing. We are dealing with politicians, and politicians have a mandate. They want power, they want to make decisions, and they want to represent their constituents.
I will say to an elected House of Lords, “This House has primacy.” The Lords will say to me, “I was elected like you, but I was elected under a more proportional system than you.” They will say, “I have a much bigger constituency than you”—which will be true—and they will say that they have been elected for a longer term than me. Most important, they will say, “We are full-time legislators.” As a constituency MP, I spend some of my time here in the Chamber debating issues and some of it dealing with constituency queries.
Dr Daniel Poulter (Central Suffolk and North Ipswich) (Con)
My hon. Friend is making a good speech, but I disagree with him. Does he not accept that a Chamber that is only 80% elected and 20% appointed inherently maintains the primacy of this place?
Oral Answers to Questions
Dan Poulter Excerpts(13 years, 9 months ago)
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Mr Hunt
Absolutely not. I recognise that Creative Partnerships has done some excellent work, and I commend in particular the leadership of Paul Collard, but the decision to remove its funding was directly caused by the enormous budget deficit that we inherited—the economic crisis from which we and the whole country now have to pick up the pieces.
Dr Daniel Poulter (Central Suffolk and North Ipswich) (Con)
T2. I know that the Minister is aware of the importance of high-speed broadband to predominantly rural counties, such as Suffolk, and in particular to the small businesses that are the backbone of our economy. Is he encouraged by the fact that in Suffolk we are developing a public-private partnership that will see local authorities committing almost £500,000 to the revenue funding of any future successful broadband bid?
The Parliamentary Under-Secretary of State for Culture, Olympics, Media and Sport (Mr Edward Vaizey)
I am certainly encouraged by what my hon. Friend tells me, and I am further encouraged, having met Suffolk county council with local Conservative MPs, who are taking a strong leadership position on that important issue.
Oral Answers to Questions
Dan Poulter Excerpts(13 years, 11 months ago)
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Hugh Robertson
The right hon. Lady is of course correct. At the time of the bid, the commitment was to leave a 25,000-seater mixed-use stadium, with athletics at its core, so we have already broken a part of that, in that there is not going to be—I would guess—a 25,000-seater stadium. I hear what she says about the future of the Olympic stadium, as I have had my ear bent on the issue by a number of hon. Members. The Olympic Park Legacy Company is going through a quasi-judicial process, so it would be inappropriate for me to comment either way at this stage, but I hear what she says.
Dr Daniel Poulter (Central Suffolk and North Ipswich) (Con)
6. What recent progress he has made on the roll-out of community broadband; and if he will make a statement.
The Parliamentary Under-Secretary of State for Culture, Olympics, Media and Sport (Mr Edward Vaizey)
My officials continue to engage with local authorities, local enterprise partnerships and the devolved Administrations regarding the next wave of funding for superfast broadband as part of the £530 million that we have secured from the TV licence fee settlement. The next locations for funded projects are due to be announced in May 2011.
Dr Poulter
As the Minister is aware, Suffolk is a particularly rural county that will derive significant economic benefits from the widespread deployment of high-speed broadband. He will be aware also of our advanced stage of preparedness in having a public-private partnership to deliver it, so will he please be a little more specific and tell us when he is going to announce the timeline for the next delivery phase of those broadband projects?
Oral Answers to Questions
Dan Poulter Excerpts(14 years ago)
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Mr Vaizey
My hon. Friend speaks up very well for his constituents in regard to this problem, which is connected with the placing of exchanges. One community is often served by two different exchanges. However, I intend to speak to the relevant operator about the issue and report back to him.
Dr Daniel Poulter (Central Suffolk and North Ipswich) (Con)
3. What steps his Department is taking to secure a sporting legacy from the London 2012 Olympics.
The Minister for Sport and the Olympics (Hugh Robertson)
I have asked Sport England to develop its £135 million places people play strategy, which along with the investment in the Olympic park will mean a new generation of iconic facilities, protection for our local playing fields and the gold challenge, which will both raise money for charity and get more people playing Olympic sports. The school Olympic-style competition will get competitive sport back in our schools, and all of this is, of course, supported by protecting both the whole sport plans and elite athlete funding in the spending review.
Dr Poulter
I am sure the Minister is aware that Ipswich has some fantastic sporting facilities, and we are greatly looking forward to hosting the Azerbaijan team during the 2012 Olympics, but may I invite him to visit Ipswich to help us in our aspirations to develop a sports village and a lasting sporting legacy for young people, and to improve healthy lifestyles in Ipswich?
Hugh Robertson
I thank my hon. Friend for that invitation, and I have indeed visited Ipswich on a number of occasions—and watched his football team win a couple of years ago. [Interruption.] I do not sound surprised at all. The scheme my hon. Friend mentions is precisely the sort of project that will benefit from the type of funding Sport England is now looking at, and I wish him every success with it.